Request a Quote - Agents

Please complete the following fields and upload the necessary documents in order to facilitate the quote process. Should you have any questions, please contact Jessica Trosclair, Assistant Underwriting Manager at jtrosclair@lra.org at (504) 636-6532.

Organization *

First Name *

Last Name *

Address Line 1

Address Line 2

City *

State

Postal Code *

Email *

Phone *

Accord

Please upload the accord document.

20MB max

Loss Runs

Please submit 3-5 years of loss runs.

20MB max

NCCI Mod Worksheet

20MB max

Request a Quote - Agents

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